中国组织工程研究

中国组织工程研究 ›› 2010, Vol. 14 ›› Issue (44): 8220-8224.doi: 10.3969/j.issn.1673-8225.2010.44.013

• 器官移植循证医学 evidence-based medicine of organ transplantation • 上一篇    下一篇

心胸比率对心脏瓣膜置换后影响的Meta分析

侯园园，周  萍   

  1. 首都医科大学生物医学工程学院，北京市  100069
  • 出版日期:2010-10-29 发布日期:2010-10-29
  • 通讯作者: 周萍，硕士，副教授，首都医科大学生物医学工程学院，北京市 100069 eduhelp@163.com
  • 作者简介:侯园园★，女，1985年生，河南省安阳市人，汉族，首都医科大学生物医学工程学院在读硕士，主要从事医学图像处理研究。 hyy200333@163.com

Effects of cardiothoracic ratio following cardiac valve replacement: A Meta-analysis

Hou Yuan-yuan, Zhou Ping   

  1. School of Biomedical Engineering, Capital Medical University, Beijing  100069, China
  • Online:2010-10-29 Published:2010-10-29
  • Contact: Zhou Ping, Master, Associate professor, School of Biomedical Engineering, Capital Medical University, Beijing 100069, China eduhelp@163.com
  • About author:Hou Yuan-yuan★, Studying for master’s degree, School of Biomedical Engineering, Capital Medical University, Beijing 100069, China hyy200333@163.com

PDF

364

被引次数

5

摘要：

背景：心脏瓣膜置换风险性高，医疗费用高，因此应充分的做好术前评估后择期手术，提高手术成功率。从X射线胸片上可以准确地测量出心胸比率的大小，了解心脏结构和功能状况。心胸比率≥0.7为重症心脏瓣膜病的表现形式之一，其手术危险性也较高。
目的：通过Meta分析，探讨心胸比率对心脏瓣膜置换后死亡率和并发症的影响，采用数据挖掘方法拟合出术前各级心功能患者的心胸比率均值。
方法：检索中国期刊全文数据库、万方数据库、维普期刊网，收集国内关于心脏瓣膜置换的研究文献并摘录有关数据，将心胸比率分为> 0.7和< 0.7两组进行Meta分析，差异评价指标以优势比(OR)和95%可信区间(CI)表示，统计学分析采用RevMan 4. 2软件。提出数据挖掘方法拟合出术前各级心功能患者的心胸比率均值。
结果与结论：共有8篇文献纳入死亡率研究，9篇文献纳入并发症研究。Meta分析结果显示，两组不同的心胸比率对术后死亡率有明显影响，对并发症也有一定的影响。8组术后死亡率数据经异质性检验结果一致(P=0.19)；而6组术后并发症数据异质性检验结果不一致(P < 0.000 1)。拟合出术前心功能Ⅱ，Ⅲ，Ⅳ级患者心胸比率均值分别为0.555 9，0.669 0，0.671 2。提示术前心胸比率大于0.7的患者，心脏瓣膜置换后早期死亡率和并发症较高，可将心胸比率作为心脏瓣膜置换的术前风险评估指标之一。按照术前心功能等级分类统计心胸比率更具有研究价值。

关键词: 心胸比率, 心脏瓣膜置换, Meta分析, 数据挖掘, 术前风险评估

Abstract:

BACKGROUND: Because of the high risk and high cost of cardiac valve replacement, it is necessary to perform pre-operative assessment for a successful operation. It can accurately measure cardiothoracic ratio (CTR) and clearly show the structure and function of the heart from the chest X-ray. If the CTR ≥ 0.7, it means severe cardiac valve disease, and operation risk is higher.
OBJECTIVE: To investigate the effects of CTR on mortality rate and complications after cardiac valve replacement according to Meta analysis, and to calculate the CTR mean of four heart function using the data mining method.
METHODS: The CNKI database, Wanfang database, and Vip database were retrieved. The literatures addressing cardiac valve replacement in China were collected from the relevant date. Meta analysis was carried out based on two groups of CTR > 0.7 and CTR < 0.7. The differences in evaluation were expressed by odds ratio (OR) and 95% confidence interval (CI). RevMan 4.2 software was used for statistical analysis. The preoperative CTR mean of four cardiac functions was calculated by the data mining method.
RESULTS AND CONCLUSION: A total of 8 articles about mortality rate, and 9 articles about complications were included. Result of meta- analysis showed that CTR had significant effects on postoperative mortality rate and complications in the two groups of CTR. Eight sets of data in postoperative mortality in the 8 literature had the same results after the heterogeneity inspection (P=0.19); however, 6 sets of data in postoperative complications in the 9 literature had the inconsistent results after the heterogeneity test (P < 0.000 1). The CTR mean of preoperative cardiac function in II, III, IV patients was 0.555 9, 0.669 0, and 0.671 2 respectively. It is indicated that if preoperative CTR > 0.7 in patients, the early mortality rate and complications is higher after the cardiac valve replacement. The CTR can be used as one of the preoperative risk assessment indexes for cardiac valve replacement. It is valuable to statistics CTR according to preoperative heart level.

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